Alternative Names

Causes

Dementia usually occurs in older age. It is rare in people under age 60. The risk of dementia increases as a person gets older.

Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer disease is the most common type of dementia.

Another common type of dementia is vascular dementia. It is caused by many small strokes.

Lewy body disease is a common cause of dementia in the elderly. People with this condition have abnormal protein structures in certain areas of the brain.

Use of certain medicines, including cimetidine and some cholesterol drugs

Symptoms

Dementia symptoms include difficulty with many areas of mental function, including:

Emotional behavior or personality

Language

Memory

Perception

Thinking and judgment (cognitive skills)

Dementia usually first appears as forgetfulness.

Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They often know about their forgetfulness. Not everyone with MCI develops dementia.

Symptoms of MCI include:

Difficulty doing more than one task at a time

Difficulty solving problems or making decisions

Forgetting recent events or conversations

Taking longer to do more difficult mental activities

Early symptoms of dementia can include:

Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines

Getting lost on familiar routes

Language problems, such as trouble with the names of familiar objects

Losing interest in things previously enjoyed, flat mood

Misplacing items

Personality changes and loss of social skills, which can lead to inappropriate behaviors

As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include:

Change in sleep patterns, often waking up at night

Difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving

Slow the rate at which symptoms get worse, though improvement with these drugs may be small

Control problems with behavior, such as loss of judgment or confusion

Outlook (Prognosis)

People with mild cognitive impairment do not always develop dementia. When dementia does occur, it usually gets worse over time. Often it decreases quality of life and lifespan. Families will likely need to plan for their loved one’s future care.

Qaseem A, Snow V, Cross JT, et al., American College of Physicians/American Academy of Family Physicians Panel on Dementia. Current pharmacologic treatment of dementia: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2008;148:370-378.